The Golfer’s Guide To Lower Back Pain Part 1
Tue Aug 19, 2014 by Dr. Greg Rose
Lower back pain is by far the most common ailment suffered by golfers of all ages. Based on data collected at TPI from over 31,000 golfers, 28.1% of all players deal with lower back pain after every round. Lower back pain is also the most common complaint seen amongst professional golfers on all tours . To understand the cause of lower back pain, it requires a thorough investigation of what I call the Body-Swing Connection. Lets take a closer look.
First of all, let me start by making a bold statement. The lower back is rarely the original cause of the pain! It may be the current of the pain, but its rarely the cause of the pain. More often than not, abnormal motions or forces coming from adjacent or distant areas of the body force the lower back to do excessive work until it completely breaks down itself. In other words, the lumbar spine is usually the area that is being unnecessarily overworked to the point of injury. It is basically the over-used and over-abused worker who just goes and goes until he or she breaks.
In my experience, the lack of mobility seen in the ankles, hips, thoracic spine and shoulders of many golfers forces the lower back to carry all of these excessive loads and is the primary cause for most back injuries. So any article about lower back pain should address those areas specifically.
When the lower back finally does break down, you can typically expect one of the following conditions to occur:
Artificial Disc Replacement To Maintain Back Mobility
If golfers need spine surgery to treat chronic lower back pain, they have two options: spinal fusion and artificial disc replacement. Both of these surgical spine procedures will likely reduce low back pain and other symptoms however, artificial disc replacement is a better option than spinal fusion for preserving spinal mobilitythe key to every golfers swing. Fused spinal bones no longer move independently. The more spinal levels that are fused, the less able the spine is to bend and twist. Artificial disc replacement replaces the disc, so the spinal bones at the treated level can continue to bend, flex, and rotate similar to the native spinal disc. Every golfer who needs low back surgery and wants to continue to play golf after the procedure should consider artificial disc replacement.
In a way, artificial disc replacement not only preserves spinal mobility, it also preserves your golf game.
Why Exercise Is Crucial In Supporting The Lumbar Region
The spine is like the mast on a ship.
The mast has all these ropes attached to it to help unload it so that it doesnt fall over and crack.
Essentially the mast cannot support its own weight without the ropes.
The same is true with our spine.
Our spine can only support 35 lbs of axial pressure on its own.
That is why we rely on certain muscles attached to the spine, commonly known as your core, to take the pressure off.
When your core muscles are weak, imbalanced, or tight instead of the muscles taking the pressure of your daily activities it is the spine that takes that pressure.
This can lead to a lot of wear and tear on the spine.
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What Can Be Done To Help Manage These Back Problems
If youre currently experiencing pain or potentially even an injury, you can manage it in a few ways.
There are a couple of things you should keep in mind when dealing with pain or injury. Firstly, continuing to play golf through an episode of low back pain can further stress inflamed muscles and joints. Taking time off will allow your back to heal more quickly. Secondly, you should continue to stretch and strengthen your back between golf sessions, along with a low-impact aerobic exercise programme, such as walking or cycling.
Finally, after the low back pain has subsided, return to playing golf slowly and apply the prevention tips below to help avoid future occurrences.
As with so many health conditions, a little effort to prevent injury goes a long way. Address these three key areas to stay out of the back-pain bunker Your body, your technique, and your bag.
Common Low Back Conditions In Golfers
The golf swing produces large loads in the spine, particularly during downswing to follow-through. These loads approach that of professional football linemen hitting a sled and are well above the force needed to prolapse intervertebral discs in cadavers.36 These intense loads can strain muscles, injure facet joints and lumbar discs, and cause spondylolysis.14,36,39 In older populations, vertebral and rib stress fractures are more likely than they are in younger populations, owing to osteoporosis.36
For a right-handed golfer, the left external oblique, L2 paraspinal musculature , and rectus abdominis are the core muscles that initiate the takeaway from address39 . At the top of the backswing, the right-sided external obliques, paraspinal muscles, and abdominals initiate the highest load of the swing and are dominant through impact. Not surprisingly, the right lumbar region in right-handed golfers is most commonly injured.39
Swing sequence. General overview of golf swing from address to top of backswing to follow-through .
The reverse-C position has the potential to cause facet irritation.25 In older populations with spinal degenerative changes, this position creates additional stress on at-risk facets. Facet arthropathy is usually treated with corticosteroids and rest from golf during initiation of therapy.39
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Exercises For Muscle Strength And Endurance
Golfers with low back pain tend to rely more heavily on the erector spinae muscle before the swing, rather than on the transversus abdominis and the multifidus.1 This tendency may be the cause of low back pain or may compensate for the weakness in the transversus abdominis or multifidus. It is important to resolve muscle imbalances by engaging and strengthening the right muscles.
To strengthen the abdominal muscles, including the transversus abdominis:
To strengthen the multifidus and other muscles surrounding the spine, one effective exercise is the bird dog pose:
It may help to place a cushion under the knees.
Playing Golf When Dealing With Sciatica Pain
Sciatica pain, nerve pain that radiates down from the lower back and through the leg, can make physical activity difficult, including playing golf. Even so, medical experts usually say that the best treatment for most sciatica often is to remain physically active and the walking involved in playing a game of golf is one of the most beneficial exercises. Keep your same strokes, but to decrease the pain while you’re golfing, make a series of stretches a part of your daily routine. If you are regularly stretching and walking and still experience debilitating sciatica pain while golfing, talk to your doctor about other treatment options.
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Relieving Lower Back Pain From A Golf Injury
To relieve the associated pain and stimulate the healing process from injuries related to golf, the advice is to take a rest for a day or two. Apply heat to the affected area and also take pain relief, such as naproxen or ibuprofen, is helpful in reducing inflammation. Acetaminophen, when taken together with the two, can help in further reducing lower back pain along with other pains.
Exercise To Build Back Strength
Weak lower back muscles usually lead to strains as a result of the intense pressure applied to the muscles from your golf swings. Exercising to build strength that targets lower back muscles can efficiently prevent injuries. Pull-down and rowing exercises are the most recommended forms of exercise here.
It is also critical that you avoid too many repetitive activities and motions.
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Sciatic Back Pain Exercises & Stretches
Golf can be a difficult game to master as it is, but when you couple it with sciatic back pain, things can go downhill in a hurry. Pain in the sciatica is commonly caused by damage to the sciatic nerve, found in the lower spine region. There are many causes of sciatic pain, so you should seek an evaluation by your physician to determine the cause.
Oftentimes, the pain associated with this common golf ailment can be alleviated by performing a series of simple exercises and stretches in the convenience of your own home.Stretching and strengthening the muscles of the abdomen, lower back and thighs can decrease sciatica pain, and get you back on the golf course where you belong.
What Causes Back Pain While Playing Golf
Swinging a golf club requires a smooth, repetitive motion involving many different muscle groups in your neck, back, arms and legs. The motion must be performed extremely fast in order to be effective. This fast, repetitive motion can do a real number on your upper and lower back muscles in particular, which may not be strong enough to handle the strain put on them. Golfers tend to be very dedicated to their sport, which is another contributing factor to the prevalence of back pain in people who play golf. Excessive playing, especially for beginners, can lead to overuse injuries. While anyone who experiences back pain from any activity should stop and rest immediately, many avid golfers refuse to stop playing when injured.
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Golf Is A Natural Cause For Pain
In the eyes of many golf instructors, that means a great golf swing doesnt necessarily correlate to one thats healthy for your back.
This is mainly because the golf swing is one-sided , with high-velocity movement through the lower back thats repeated over and over again. Repetition in this manner makes the lower back tissues, such as discs and joints, subjected to very high loads that can wear down and degenerate much faster than other areas of the body.
The result is often tight, painful muscles that over time can lead to serious conditions such as disc bulges and herniations, arthritis, stenosis and more.
Golfing With Low Back Pain Lumbar Stenosis And After Spine Surgery
Golf is one of the most popular sports in the world and its a great form of exercise that can be enjoyed by men and women of all age groups. One of the unfortunate downsides to the sport is the strain it can put on your lower back. This article will focus on not only the prevention of a lower back injury from playing golf, but also how to enjoy the game if you are someone who has been diagnosed with lumbar spinal stenosis or has had spine surgery in the past.
As with any sports related injury, prevention is key. Here are some tips to preventing low back pain from golfing:
Some patients suffer from a condition called lumbar spinal stenosis, where the canal that contains the nerves in the lower back is narrowing and can cause low back and sciatica pain. Here are some additional tips for this group of patients who want to continue to play golf:
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The Backswing Or Takeaway
Once the club starts to move, the erector spinae and abdominal oblique muscles are activated on the left side, assuming the golfer is right-handed. At the start of the swing:
- Stand closer to the ball
- Keep the backswing short, to help reduce the load on the back3
- Rotate the head slightly, with the nose aligning over the right foot, rather than keeping the head still
Switching to a short backswing will require training or practice, to prevent strain in the shoulder muscles. An added benefit of this modification is improved shot accuracy.
Modify The Golf Swing
An ideal golf swing is smooth, fluid, and rhythmic. Understanding the biomechanics of the swing helps to prevent back injuries such as muscle strains. Modification of the golf swing may be necessary in the injured or elderly athlete.
Modifications are applicable to all 4 components of the golf swing2:
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Limit The Forces On The Lower Back
Younger golfers, between 30 and 40 years old, tend to swing the hardest while playing golf. In this age range, conditions such as degenerative disc disease or isthmic spondylolisthesis more commonly affect the lower back. It is important to understand the forces at play to achieve a fluid and safe golf swing.
Three biomechanical forces or loads are applied to the lower back during golf:
Improve The Swing To Prevent Back Pain
It is important to practice swinging before playing golf, as this part of the warm-up routine helps to prevent low back pain. Besides practicing the swing, improving the technique will also prevent injury to the back. Two common techniques include:
- The classic swing. Traditionally, the golf swing equally rotates the lower back, pelvis, and shoulder. Momentum moves in the forward direction.
- The modern swing. This popular variation limits the movement of the pelvis and increases the rotation of the torso or chest. Momentum moves in the upward direction. A high clubhead speed and a high ball trajectory are generated, but the lumbar spine may not be able to withstand the increased forces.4
A classic swing allows the hips to rotate during the backswing, ultimately providing the lower back some much needed relief. Although the more powerful modern swing is commonplace today, the risk to the spine is not worth the increased speed.
The following 4 aspects of the golf stance reduce risk of injury5:
The correct set-up ensures that minimal muscular effort is required, with minimal load on the spinal discs and facet joints. During the swing, the correct technique will distribute the load evenly across the shoulder, hip, and lower spine.
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Is Lower Back Pain Common In Golf
Lower back pain common in golf is very common. The lower back is the most common site of injury in men golfers and second most common in women golfers. In fact, low back injuries make up more than half of all golf-related injuries in men and more than a third of golf-related injuries in women. Low back pain is number one injury in the PGA Tour.
Golf Swing For Bad Back
You love to golf, but your back is holding you.back. Youre probably wondering if its even possible to have a decent golf swing with a bad back.
When you think of sports that are likely to be risky, golf will rarely ever cross your mind. Nonetheless, orthopedic injuries that result from golf are very common. Statistics show that about 20% of all golfers at one time or another suffer from some sort of injury every year.
Out of the injuries that occur, back pain from golf swing stands out as the most common of all. Actually, back pain resulting from golfing activities represents a fifth of all the injuries that are reported by golfers.
Though back pain is common, it is not easily avoidable. To mitigate the risk of golfers suffering from golf back injuries, simple precautionary measures can be taken. Here we are going to take a look into a number of techniques that may be used to avoid back pain as you take your golf swing.
Other injuries to either the elbows, the shoulders, or the wrist usually come as compensation to save the back.
The majority of acute lower back injuries occurring during golfing have the tendency to get better over a few days to maybe a week.
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